1. Payment for all Services except abortion Affordability Credits*** Federal Government Required: PAY ABORTION PREMIUM (even if you object or never plan to have an abortion) TO INSURANCE PLAN 1040 (individual’s tax payment) Pay premium for all services except abortion to insurance plan Pay premium to insurance plan Enroll—unintentionally, through employment, or by choice--in private plan within a state Exchange that COVERS ABORTIONS** Enroll in private plan within a state Exchange that does not cover abortions Payment for abortions Note: Americans in states that have an “opt-out” (see Chart B) will subsidize abortion coverage through their tax dollars in states without opt- outs. Payment for all services (no abortion coverage) For qualified individuals * The ACA fails to comprehensively prohibit the use of federal tax dollars auth. by and/or approp. through the Act for abortions or abortion coverage; as a result, several states attempted to obtain funding for abortions through their high-risk insurance pool proposals. Only after their efforts were exposed did HHS issue regulations prohibiting abortion coverage through the pools (an action the administration stated “is not precedent” for other ACA programs). **The Exchanges and private insurance plans within the Exchanges are prohibited from advertising abortion coverage. Insurance plans may only provide a notice to enrollees of abortion coverage as part of the summary of benefits and coverage explanation, at the time of enrollment. ***Under the ACA, if the Hyde Amendment is removed from LHHS approps, federal funds will directly pay for abortions (the separate “abortion premium” will no longer be necessary). Regardless of whether federal funds directly pay for abortions, however, federal funding of insurance plans that cover abortions is a radical change from existing law (e.g., the Hyde Amendment and the FEHBP). AMERICANSAMERICANS OR Chart A: Abortion Funding* and Coverage under the Affordable Care Act For qualified individuals Enroll in insurance plan outside an Exchange OR

2. Chart B: How an Abortion-Mandate “Opt-Out” Works STATESTATE An Opt-Out Ensures: Federal tax dollars do not subsidize insurance plans that cover abortions within that state** and No citizens in that state will pay a separate “abortion premium” ENACTS: A law prohibiting private insurance plans that cover abortions from participating in Exchanges within that State* An Opt-Out Does Not: Resolve all of the abortion-related problems in the ACA*** or Prevent a state’s citizens from subsidizing abortion coverage in other states with their federal tax dollars * Pursuant to Section 1303(a) of the Affordable Care Act: “A State may elect to prohibit abortion coverage in qualified health plans offered through an Exchange in such State if such State enacts a law to provide for such prohibition.” **Most states have exceptions for abortions in cases of life, rape, and incest. *** E.g., the lack of a comprehensive prohibition on abortion funding or coverage; conscience problems; the HHS coverage mandate.